Provider Demographics
NPI:1790428134
Name:RAMOS, MIRIAM DEL ROSARIO (MD)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:DEL ROSARIO
Last Name:RAMOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1403 LOMITA BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-2086
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1403 LOMITA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-2086
Practice Address - Country:US
Practice Address - Phone:310-602-2550
Practice Address - Fax:310-257-4991
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-14
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program